Dr. Melody Nguyen

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment (CAT) based on mental and behavioural disorders, and entitlement to a post-104-week income replacement benefit (IRB).

The Licence Appeal Tribunal found that while the applicant sustained psychological impairments from the accident, she did not meet the Criterion 8 threshold for CAT, as she demonstrated only moderate impairments across the four spheres of functioning.

The Tribunal also dismissed the claim for an IRB, finding the applicant failed to prove a complete inability to engage in suitable employment, preferring the respondent's multi-disciplinary assessment.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not qualify for a non-earner benefit.

The Licence Appeal Tribunal found the applicant failed to prove her pre-existing psychological condition prevented maximal recovery within the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, finding the medical evidence demonstrated the applicant continued to engage in her pre-accident activities and did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered from physical injuries and chronic pain that warranted removal from the MIG.

The Tribunal found that the medical evidence, including records from the applicant's family physician and a physiatry assessment, supported a diagnosis of minor soft tissue injuries.

The applicant failed to provide sufficient evidence of chronic pain or functional impairment.

The application was dismissed, and the disputed treatment plans and interest were denied.

The applicant sought income replacement benefits and medical rehabilitation benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of his employment for the first 104 weeks, or a complete inability to engage in any employment thereafter.

The Tribunal also found the proposed treatment plans for physiotherapy and chiropractic services were not reasonable and necessary, as the medical evidence did not support continued intervention.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer held that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant argued that the denial notices contravened s. 38(8) of the Schedule, which should mandate payment.

The Tribunal found that the denial notices were sufficient and met the statutory requirements.

Furthermore, based on the medical evidence, the applicant failed to prove his injuries fell outside the MIG.

As the MIG limit was functionally exhausted, the application for the disputed treatment plans was dismissed.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including treatment plans for physiotherapy, chiropractic, psychological, and optometric services, as well as prescription expenses.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant was entitled to the psychological services and a portion of the prescription expenses, as the medical evidence supported a diagnosis of post-traumatic stress disorder and chronic pain related to the accident.

However, the Tribunal dismissed the claims for physiotherapy, chiropractic, and optometric services, preferring the respondent's insurer examinations which found these treatments were not reasonable and necessary.

The applicant's claim for a special award under s. 10 of O. Reg. 664 was dismissed, as the respondent's reliance on its medical experts was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several treatment plans and withheld payment for approved services, arguing the service provider failed to provide requested information.

The Tribunal found it had jurisdiction to hear the dispute over withheld payments and ordered the respondent to pay the approved amounts, less $400 for unexplained supplementary goods.

The Tribunal dismissed the applicant's claims for further physiotherapy, a social work assessment, and disability certificates, finding them not reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident.

In a prior Tribunal decision, it was determined that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant filed a second application seeking to remove herself from the MIG based on new medical reports.

The Tribunal dismissed the application, finding that the issue was barred by res judicata.

The Tribunal held that the new medical evidence did not conclusively impeach the original results, as the experts relied heavily on self-reporting and one expert lacked the appropriate orthopaedic qualifications.

The respondent's request for costs was denied.

The Applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment, attendant care benefits, and medical benefits.

The Insurer denied the claims, arguing the Applicant's ongoing issues were related to pre-existing conditions and that he was malingering.

The Arbitrator found the Applicant and his family members lacked credibility, noting significant inconsistencies between their testimony, the Applicant's pre-accident medical history, his receipt of ODSP benefits, and surveillance evidence showing him performing normal daily activities.

The Arbitrator preferred the evidence of the Insurer's medical experts, who found the Applicant was malingering and that his impairments were not caused by the accident.

The claims for catastrophic impairment, attendant care benefits, and medical benefits were dismissed.